ABSTRACT
En los últimos años se han producido avances en el manejo de la hemorragia digestiva alta no varicosa que han permitido disminuir la recidiva hemorrágica y la mortalidad. El presente documento de posicionamiento de la Societat Catalana de Digestologia es una actualización de las recomendaciones basadas en la evidencia sobre el manejo de la hemorragia digestiva por úlcera péptica
In recent years there have been advances in the management of non-variceal upper gastrointestinal bleeding that have helped reduce rebleeding and mortality. This document positioning of the Catalan Society of Digestologia is an update of evidence-based recommendations on management of gastrointestinal bleeding peptic ulcer
Subject(s)
Humans , Gastrointestinal Hemorrhage/therapy , Peptic Ulcer Hemorrhage/therapy , Practice Patterns, Physicians' , Evidence-Based Practice , Endoscopy, Gastrointestinal , Blood Coagulation Disorders/drug therapy , Prognosis , Helicobacter Infections/drug therapy , Sclerosing Solutions/administration & dosageABSTRACT
In recent years there have been advances in the management of non-variceal upper gastrointestinal bleeding that have helped reduce rebleeding and mortality. This document positioning of the Catalan Society of Digestologia is an update of evidence-based recommendations on management of gastrointestinal bleeding peptic ulcer.
Subject(s)
Hemostatic Techniques , Peptic Ulcer Hemorrhage/therapy , Anti-Inflammatory Agents, Non-Steroidal/adverse effects , Anti-Ulcer Agents/therapeutic use , Anticoagulants/adverse effects , Biomarkers/blood , Combined Modality Therapy , Comorbidity , Contraindications, Drug , Crystalloid Solutions , Disease Management , Endoscopy, Gastrointestinal , Erythrocyte Transfusion , Erythromycin/therapeutic use , Helicobacter Infections/complications , Helicobacter Infections/drug therapy , Helicobacter pylori , Humans , Hypotension/etiology , Hypotension/therapy , Intubation, Gastrointestinal , Isotonic Solutions/therapeutic use , Liver Cirrhosis/complications , Liver Cirrhosis/diagnosis , Peptic Ulcer Hemorrhage/blood , Peptic Ulcer Hemorrhage/etiology , Physical Examination , Recurrence , Risk Factors , Vitamin K/therapeutic useABSTRACT
AIM: To evaluate the rate of adverse events (AEs) during consecutive gastric and duodenal polypectomies in several Spanish centers. METHODS: Polypectomies of protruded gastric or duodenal polyps ≥ 5 mm using hot snare were prospectively included. Prophylactic measures of hemorrhage were allowed in predefined cases. AEs were defined and graded according to the lexicon recommended by the American Society for Gastrointestinal Endoscopy. Patients were followed for 48 h, one week and 1 mo after the procedure. RESULTS: 308 patients were included and a single polypectomy was performed in 205. Only 36 (11.7%) were on prior anticoagulant therapy. Mean polyp size was 15 ± 8.9 mm (5-60) and in 294 cases (95.4%) were located in the stomach. Hemorrhage prophylaxis was performed in 219 (71.1%) patients. Nine patients presented AEs (2.9%), and 6 of them were bleeding (n = 6, 1.9%) (in 5 out of 6 AE, different types of endoscopic treatment were performed). Other 24 hemorrhagic episodes could be managed without any change in the outcome of the endoscopy and, consequently, were considered incidents. We did not find any independent risk factor of bleeding. CONCLUSION: Gastroduodenal polypectomy using prophylactic measures has a rate of AEs small enough to consider this procedure a safe and effective method for polyp resection independently of the polyp size and location.
